On Friday, Moffeit learned that the governor’s office has ordered a “deep and comprehensive look’’ at health care facilities owned by Mahmood, whose chain of rural hospitals avoided serious regulatory action despite years of endangering patients.

The inspector general for the state Health and Human Services Commission and one of the agencies it oversees, the state health department, will conduct separate investigations, officials said Friday.

The disclosure came after The Dallas Morning News sought the governor’s response to comments made by Sen. Wendy Davis, D-Fort Worth. She called on Gov. Rick Perry and other lawmakers to not “drag their feet’’ in seeking a quick determination of “the scope and severity of patient abuse and deaths’’ in Mahmood’s hospital chain.

Perry’s spokeswoman, Lucy Nashed, said the governor expected the inspector general and the health department “to thoroughly review this and any other allegations to ensure Texans are receiving safe and effective medical care.’’ She did not say when Perry requested the investigation.

“We’ve been in verbal communication with both agencies,’’ Nashed said in an email. “We asked them to coordinate efforts to investigate these allegations and determine what steps are necessary to prevent a similar situation.’’

In an interview this week with the Tribune, Shannon was quoted as saying he was “proud of some of the accomplishments we made in Parkland” during his 2007-2012 tenure. He went on to say:

“But clearly we had some spectacular medical failures. And no one is proud of that, no one’s happy about that. … I’m very sorry that I didn’t see them across the finish line. They’ll be going through a re-survey, and I’m quite sure they will be successful this time.”

Shannon told the Tribune that he had worked closely with safety monitors installed by the U.S. Centers for Medicare & Medicaid Services after a 2011 inspection found patients were in “immediate jeopardy.” By April, Parkland is scheduled to undergo a re-inspection to test whether patient-care corrections are working.

Here's a mock-up of what a maternity patient's room could look like at the new Parkland, which is scheduled to open in 2015.

This post was updated at 3:40 p.m. today, Dec. 4, 2012 and again at 10:10 a.m Dec. 5.

State regulators are hitting Parkland Memorial Hospital again because of patient-safety breakdowns.

Dallas County’s troubled public hospital failed to investigate two sudden, unexpected deaths and a third case in which a patient “was suspected of having blood transfusion complications,” the Texas Department of State Health Services says. Such internal investigations are legally required.

One death involved a cardiac patient on the day of scheduled discharge. The patient was experiencing rapid heartbeat and low blood pressure when injected with metoprolol, a drug often used to treat high blood pressure.

“Less than one minute later, patient became unresponsive” and soon died, says a violation notice that DSHS sent to Parkland last week.

The second cited death involved a pregnant woman who came to the labor and delivery unit “with complaints of leaking amniotic fluid.” The next day, she felt nauseated, had trouble breathing and suffered a seizure. She died as doctors prepared for a possible cesarean section. So did the fetus.

The violation notice doesn’t say what happened to the transfusion patient. All the cases occurred this summer.

Parkland hasn’t responded to a request for comment about this matter. UPDATE #1: Parkland spokeswoman April Foran just issued this comment via email: “Parkland has received three findings of violations that will cost the hospital $650 each. One violation was for a documentation error. The other two were in response to Parkland’s failure to follow its policy regarding investigations of adverse events. Neither issue put any patient at clinical risk.

“These findings resulted from issues Parkland self-reported to the state. Since summer, when these events occurred, Parkland has redesigned its Quality and Patient Safety Department in order to streamline and speed up our reporting of adverse events to the state. On the documentation issue, our nursing department implemented corrective education to ensure all reports are completed correctly in the future. Parkland has been and will continue to cooperating fully with the state on these types of issues.” Continue reading →

As we told you last month, the fine by the Department of State Health Services is the largest ever given to a Texas hospital. It is 20 times as much as the previous largest — $50,000 assessed against Houston’s Ben Taub General Hospital in 2007.

Parkland said last month it had reached the deal to avoid further legal action into complaints made between Jan. 1, 2011, and May 31, 2012.

Sherry is at this morning’s meeting and tells me hospital board members unanimously gave their approval without any public discussion. Paul Leslie, the hospital’s top lawyer, appeared to read portions of the settlement agreement, but provided no additional explanation.

Hospital officials declined to comment after the vote, Sherry reports. They referred her to previous written statements made by board chairwoman Debbie Branson, who signed the agreement last month. Parkland acknowledged no wrongdoing as part of the deal.

In the agreement, state safety regulators highlighted nine examples of poor patient care as part of an “influx of complaints” at Parkland.

A hospital spokeswoman says Stella Coker, a registered nurse and director of the care management department, is quitting for family reasons and not because of allegations that were made public in a lawsuit last week.

In the suit, longtime Parkland social worker Sandra Palmer says she was fired after complaining to state regulators about Coker and other managers. The Texas Department of State Health Services says it’s investigating the matter.

Another wrongful-termination lawsuit that names big names has been filed against Parkland Memorial Hospital.

Longtime social worker Sandra Palmer, as you can see below, says her bosses told her last fall “to start transcribing medication vouchers,” “discussing medication options with doctors,” “identifying low-price generics” and discussing drug interactions with patients. “Not being a nurse, Palmer questioned whether this practice is outside the scope of her certification” and unsafe. She asked supervisors for documentation from state regulators “that it is okay for a social worker to transcribe prescription vouchers.” The bosses “were unable to produce any document” and ordered her to do the work.

The Texas Department of State Health Services says social workers aren’t allowed to do what Palmer’s suit describes.

“It’s never appropriate for a social worker to transcribe medication vouchers or to make recommendations regarding medication options or dosages,” DSHS spokeswoman Christine Mann told me in an email. “It is not within the scope of practice.”

Palmer’s suit says that on Dec. 20, she complained in writing to Dr. Thomas Royer (above right), Parkland’s interim CEO. “Royer responded that Palmer should not engage in any activities that could endanger patients’ lives and that his senior management team would immediately look into Palmer’s concerns.”

State inspectors have returned to troubled Parkland Memorial Hospital this week to investigate new patient-harm complaints.

Authorities said one focus is the psychiatric emergency room, whose failings triggered the crisis that began unfolding in May at Parkland and has led to its being the largest U.S. hospital ever to face a rare form of intensive federal oversight.

“We have been on site at Parkland since Tuesday,” Department of State Health Services spokeswoman Carrie Williams confirmed today. She said she couldn’t give more details about about what investigators were focusing on.

But even as Parkland officials promised to fix those problems, psych ER employees failed in dangerous fashion again: In August, they forced a nearly naked, barely conscious patient to leave the hospital alone in the darkness.

Here it is mid-November, and the state health department’s Web site still doesn’t say which private health-care providers have received swine flu vaccine. See the “Vaccine Locations” section on this page? There’s no link — just the words “Coming Soon.”

Coming soon? Now that about 22 million people have gotten sick around the country and 3,900 have died?

The Dallas Morning News got tired of waiting for the state to provide data. So reporter Jeffrey Weiss wrote an open-records request for vaccine shipment information. What resulted is our own searchable database of providers in the Dallas area who are supposed to have the shots and mist. Check it out.

Do you have a tip about swine flu? The Department of State Health Services? Send me an e-mail and let me know. Or join the conversation by commenting below.

Now a spokeswoman for Jeff Vitt’s Star Medical Group says he did nothing wrong and blames the dispute on a communication problem — failure to clarify the distinction between Star Medical and another Vitt company called Flu Shots of America.

Texas health department spokeswoman Carrie Williams said Friday that Star claimed to be a private medical practice, making it eligible for an early shipment of vaccine. The state’s theory has been that such practices are the best way to reach the highest-risk patients first.

But Vitt’s business turned out to be what the state calls a mass vaccinator, and it was selling shots to anyone willing to pay $20.